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International Journal of Computer Assisted Radiology and Surgery

Published in:

01-08-2018 | Original Article

Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair

Authors: Katharina Breininger, Shadi Albarqouni, Tanja Kurzendorfer, Marcus Pfister, Markus Kowarschik, Andreas Maier

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 8/2018

Abstract

Purpose

Fusion of preoperative data with intraoperative X-ray images has proven the potential to reduce radiation exposure and contrast agent, especially for complex endovascular aortic repair (EVAR). Due to patient movement and introduced devices that deform the vasculature, the fusion can become inaccurate. This is usually detected by comparing the preoperative information with the contrasted vessel. To avoid repeated use of iodine, comparison with an implanted stent can be used to adjust the fusion. However, detecting the stent automatically without the use of contrast is challenging as only thin stent wires are visible.

Method

We propose a fast, learning-based method to segment aortic stents in single uncontrasted X-ray images. To this end, we employ a fully convolutional network with residual units. Additionally, we investigate whether incorporation of prior knowledge improves the segmentation.

Results

We use 36 X-ray images acquired during EVAR for training and evaluate the segmentation on 27 additional images. We achieve a Dice coefficient of 0.933 (AUC 0.996) when using X-ray alone, and 0.918 (AUC 0.993) and 0.888 (AUC 0.99) when adding the preoperative model, and information about the expected wire width, respectively.

Conclusion

The proposed method is fully automatic, fast and segments aortic stent grafts in fluoroscopic images with high accuracy. The quality and performance of the segmentation will allow for an intraoperative comparison with the preoperative information to assess the accuracy of the fusion.

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Title: Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair
Authors: Katharina Breininger
Shadi Albarqouni
Tanja Kurzendorfer
Marcus Pfister
Markus Kowarschik
Andreas Maier
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: International Journal of Computer Assisted Radiology and Surgery / Issue 8/2018
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-018-1779-6

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Intraoperative stent segmentation in X-ray fluoroscopy for endovascular aortic repair

Abstract

Purpose

Method

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Method

Results

Conclusion

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